How much rates vary
Facilitymedian $1,698 · 10th to 90th $724 to $7,244Professionalmedian $933 · 10th to 90th $708 to $3,162
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $1,000.00 Median $5,754.40 Typical High $15,848.93 | Facility | None | $1,000.00 | $5,754.40 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $933.25 Typical High $1,659.59 | Professional | None | $776.25 | $933.25 | $1,659.59 |
Ambetter Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,778.28 | $1,778.28 | $1,778.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $6,309.57 Typical High $13,489.63 | Facility | None | $2,884.03 | $6,309.57 | $13,489.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $707.95 Median $812.83 Typical High $2,511.89 | Professional | None | $707.95 | $812.83 | $2,511.89 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,737.80 Typical High $6,456.54 | Facility | None | $100.00 | $1,737.80 | $6,456.54 |
Blue Shield Setting Professional Modifier None Typical Low $549.54 Median $776.25 Typical High $1,202.26 | Professional | None | $549.54 | $776.25 | $1,202.26 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $630.96 Median $954.99 Typical High $1,412.54 | Professional | None | $630.96 | $954.99 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $1,778.28 Typical High $3,388.44 | Facility | None | $575.44 | $1,778.28 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $977.24 Typical High $1,584.89 | Professional | None | $812.83 | $977.24 | $1,584.89 |
Contra Costa Health Setting Professional Modifier None Typical Low $426.58 Median $954.99 Typical High $1,380.38 | Professional | None | $426.58 | $954.99 | $1,380.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $758.58 Median $1,096.48 Typical High $2,398.83 | Professional | None | $758.58 | $1,096.48 | $2,398.83 |
Lucent Health Setting Professional Modifier None Typical Low $7,244.36 Median $7,244.36 Typical High $8,511.38 | Professional | None | $7,244.36 | $7,244.36 | $8,511.38 |
Molina Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,412.54 | Professional | None | $851.14 | $851.14 | $1,412.54 |
Providence Setting Facility Modifier None Typical Low $707.95 Median $1,698.24 Typical High $3,801.89 | Facility | None | $707.95 | $1,698.24 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $812.83 Median $954.99 Typical High $1,584.89 | Professional | None | $812.83 | $954.99 | $1,584.89 |
Sutter Health Plus Setting Professional Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $3,311.31 | Professional | None | $2,754.23 | $2,754.23 | $3,311.31 |
United Setting Facility Modifier None Typical Low $691.83 Median $977.24 Typical High $4,466.84 | Facility | None | $691.83 | $977.24 | $4,466.84 |
United Setting Professional Modifier None Typical Low $660.69 Median $891.25 Typical High $1,778.28 | Professional | None | $660.69 | $891.25 | $1,778.28 |
12 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier 52 · Reduced service Typical Low $398.11 Median $426.58 Typical High $501.19 | Facility | 52 · Reduced service | $398.11 | $426.58 | $501.19 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $158.49 Median $169.82 Typical High $199.53 | Facility | 53 · Discontinued | $158.49 | $169.82 | $199.53 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $602.56 Median $630.96 Typical High $758.58 | Facility | 54 · Surgery only | $602.56 | $630.96 | $758.58 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $120.23 Median $128.82 Typical High $151.36 | Facility | 55 · Aftercare only | $120.23 | $128.82 | $151.36 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $79.43 Median $85.11 Typical High $100.00 | Facility | 56 · Pre-op care only | $79.43 | $85.11 | $100.00 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $588.84 Typical High $707.95 | Facility | 78 · Unplanned return to OR | $562.34 | $588.84 | $707.95 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $371.54 Median $426.58 Typical High $501.19 | Professional | 52 · Reduced service | $371.54 | $426.58 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $169.82 Typical High $199.53 | Professional | 53 · Discontinued | $147.91 | $169.82 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $630.96 Typical High $758.58 | Professional | 54 · Surgery only | $562.34 | $630.96 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $128.82 Typical High $151.36 | Professional | 55 · Aftercare only | $112.20 | $128.82 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $85.11 Typical High $100.00 | Professional | 56 · Pre-op care only | $74.13 | $85.11 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $588.84 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $524.81 | $588.84 | $707.95 |
Where California sits
The same service costs 4.4 times more in Alaska than in Texas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
California· 38th of 51
$955
AK $3,311TX $759
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.